Individual
REBECCA LOERZEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
9451 MAPLE GROVE PKWY, MAPLE GROVE, MN 55311-5447
(763) 416-2312
(763) 416-2314
Mailing address
9451 MAPLE GROVE PKWY, MAPLE GROVE, MN 55311-5447
(763) 416-2312
(763) 416-2314
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2871
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
07567WA
BLUE CROSS BLUE SHIELD
MN
01
—
2202576
MEDICA
MN
01
—
24022
SPECTERA
MN
01
—
979841032352
PREFERRED ONE
MN
Enumeration date
09/06/2006
Last updated
02/07/2023
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